Virginia took a big step Thursday toward eliminating most of the state's 21 abortion clinics, approving a bill that would likely make rules so strict the medical centers would be forced to close, Democrats and abortion rights supporters said.

Gov. Bob McDonnell, a Republican and Catholic, supports the measure and when he signs it into law, Virginia will become the first state to require clinics that provide first-trimester abortions to meet the same standards as hospitals. The requirements could include anything from expensive structural changes like widening hallways to increased training and mandatory equipment the clinics currently don't have.

While abortion providers must be licensed in Virginia, the clinics resemble dentists' offices and are considered physicians offices, similar to those that provide plastic and corrective eye surgeries, colonoscopies and a host of other medical procedures....